The Influence of Acid-Base Balance on Anesthetic Muscle Relaxants: A Comprehensive Review on Clinical Applications and Mechanisms

01 July 2024 : Review article

Paweł Radkowski

^123ABCDEFG, Maciej Szewczyk

^4ABCDEFG*, Aleksandra Czajka

^12F, Milena Samiec

^12F, Małgorzata Braczkowska-Skibińska

^1FG

DOI: 10.12659/MSM.944510

Med Sci Monit 2024; 30:e944510

Introduction Acid-Base Balance Disturbances Characteristic of Non-Depolarizing Muscle Relaxants The Use of Non-Depolarizing Muscle Relaxants in Acidosis and Alkalosis Characteristic of Depolarizing Muscle Relaxants The Use of Depolarizing Muscle Relaxants in Acidosis and Alkalosis Monitoring and Management Use of Muscle Relaxants in Metabolic and Neuromuscular Disorders Future Directions Conclusions References

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Table 1 Values of parameters assessed in arterial blood gas analysis evaluated during the differentiation of acid-base balance disorders.

Type of acid-base disorder	pH	pCO2 [mmHg]	HCO3− [mEq/L]
Metabolic acidosis	<7.35	35–45	<21
Partially compensated metabolic acidosis	<7.35	<35	<21
Respiratory acidosis	<7.35	>45	21–28
Partially compensated respiratory acidosis	<7.35	>45	>28
Metabolic alkalosis	>7.45	35–45	>28
Partially compensated metabolic alkalosis	>7.45	>45	>28
Respiratory alkalosis	>7.45	<35	21–28
Partially compensated respiratory alkalosis	>7.45	<35	<21
pCO – partial pressure of carbon dioxide; HCO – bicarbonate ions

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